Abstract
Objective: To assess differences in cheese and milk consumption across socioeconomic groups in representative samples from several European countries.
Design: A meta-analysis of published and unpublished surveys of food habits performed in nine European countries between 1985 and 1999. Educational and occupational levels were used as indicators of socio-economic status.
Results: A higher socioeconomic status was associated with a greater consumption of cheese. The pooled estimate of the difference in cheese consumption between women in the highest vs the lowest educational level was 9.0 g/day (95% CI: 7.1 to 11.0). The parallel observation in men was 6.8 g/day (95% CI: 3.4 to 10.1). Similar results were obtained using occupation as an indicator of socioeconomic status. The pooled estimates of the higher cheese consumption among subjects belonging to the highest (vs the lowest) occupational level were 5.1 g/day (95% CI: 3.7 to 6.5) in women and 4.6 g/day (95% CI: 2.1 to 7.0) in men. No statistically significant associations were found for milk consumption concerning educational or occupational level.
Conclusions: Our findings suggest that consumption of cheese is likely to be higher among subjects belonging to higher socioeconomic levels. We did not find enough evidence to support that milk intake is different according to educational or social levels.
Sponsorship: FAIR-program of the European Union (project, FAIR-97-3096).
This is a preview of subscription content, access via your institution
Access options
Subscribe to this journal
Receive 12 print issues and online access
$259.00 per year
only $21.58 per issue
Buy this article
- Purchase on Springer Link
- Instant access to full article PDF
Prices may be subject to local taxes which are calculated during checkout
Similar content being viewed by others
References
Arija V, Salas Salvadó J, Fernández-Ballart J, Cucó G & Martí-Henneberg C (1996): Consumption, alimentary habits and nutritional state of the population of Reus, Spain (IX). The evolution of food consumption, the participation in energy and nutrient intake and the relationship with socioeconomic and cultural level from 1983 to 1993. Med. Clin. (Barc) 106, 174–179.
Ascherio A, Hennekens C, Willet WC, Sacks F, Rosner B, Manson J, Witteman J & Stampfer MJ (1996): Prospective study of nutritional factors, blood pressure, and hypertension among US women. Hypertension. 27, 1065–1072.
Baghurst KI, Record SJ, Baghurst PA, Syrette JA, Crawford D & Worsley A (1990): Sociodemographic determinants in Australia of the intake of food and nutrients implicated in cancer etiology. Med. J. Aust. 1453, 444–452.
Bendich A (2001): Micronutrients in women's health and inmune function. Nutrition. 17, 858–867.
Borrell C, Domínguez-Berjón F, Pasarín MI, Ferrando J, Rohlfs I & Nebot M (2000): Social inequalities in health related behaviours in Barcelona. J. Epidemiol. Community Health. 54, 24–30.
Buzzard M . (1998): 24-Hour dietary recall and food record methods. In Nutritional epidemiology, ed. W Willet, pp 50–73. New York: Oxford University Press.
Dawson-Hughes B . (1998): Osteoporosis treatment and the calcium requirement. Am. J. Clin. Nutr. 67, 5–6.
del Rio Barquero L, Romera Baures M, Pavia Segura J, Setoain Quinquer J, Serra Majem L, Garces Ruiz P, Lafuente Navarro C & Domenech Torne FM (1992): Bone mineral density in two different socio-economic population groups. Bone Minerol. 18, 159–168.
DerSimonian R & Laird N (1986): Meta-analysis in clinical trials. Control Clin. Trials. 7, 177–188.
Dickersin K (2002): Systematic reviews in epidemiology: why are we so far behind? Int. J. Epidemiol. 31, 6–12.
EPIC Group of Spain (1999): Relative validity and reproducibility of a diet history questionnaire in Spain. I. Foods. European Prospective Investigation into Cancer and Nutrition. Eur. J. Clin. Nutr. 53, 174–180.
Erkkilä AT, Sarkkinen ES, Lehto S, Pyörälä K & Uusitupa MIJ (1999): Diet in relation to socioeconomic status in patients with coronary heart disease. Eur. J. Clin. Nutr. 52, 662–668.
European Commission (1998): Report on Osteoporosis in the European Community: Action and Prevention. Luxembourg: Office for Official Publications for the European Commission.
Fraser GE, Welch A, Luben R, Bingham SA & Day NE (2000): The effect of age, sex, and education on food consumption of a middle-aged English Cohort-EPIC in East Anglia. Prev. Med. 30, 26–34.
Gennari C (2001): Calcium and vitamin D nutrition and bone disease of the elderly. Public Health Nutr. 4, 547–559.
Greenland S (1998). Meta-analysis. In Modern Epidemiology, eds KJ Rothman & S Greenland, pp 643–673. Philadelphia, PA: Lippincott Raven.
Groth MV, Fagt S & Brondsted L (2001): Social determinants of dietary habits in Denmark. Eur. J. Clin. Nutr. 55, 959–966.
Hedges LV (1982): Estimation of effect size from a series of independent experiments. Psychol. Bull. 92, 490–499.
Hulshof KF, Löwik MR, Kok FJ, Wedel M, Brants HA, Hermus RJ & ten Hoor F (1991): Diet and other life-style factors in high and low socio-economic groups (Dutch Nutrition Surveillance System). Eur. J. Clin. Nutr. 45, 441–450.
Hupkens CLH, Knibbe RA & Drop MJ (2000): Social class differences in food consumption. The explanatory value of permissiveness and health and cost considerations. Eur. J. Public. Health. 10, 108–113.
Irala-Estévez J, Groth M, Johanson L, Oltersdorf U, Prätälä R & Martínez-González MA (2000): A systematic review of socio-economic differences in food habits in Europe: consumption of fruits and vegetables. Eur. J. Clin. Nutr. 54, 706–714.
Iso H, Stampfer MU, Manson JE, Rexrode K, Hennekens CH, Colditz GA, Speizer FE & Willett WC (1999): Prospective study of calcium, potassium, and magnesium intake and risk of stroke in women. Stroke 30, 1772–1779.
James WP, Nelson M, Ralph A & Leather S (1997): Socioeconomic determinants of health. The contribution of nutrition to inequalities in health. BMJ. 314, 1545–1549.
Johansson L, Thelle DS, Solvoll K, Bjorneboe GE & Drevon CA (1999): Healthy dietary habits in relation to social determinants and lifestyle factors. Br. J. Nutr. 81, 211–220.
Kunst AE & Mackenbach JP (1994a): International variation in the size of mortality differences associated with occupational status. Int. J. Epidemiol. 23, 742–750.
Kunst AE & Mackenbach JP (1994b): The size of mortality differences associated with educational level in nine industrialized countries. Am. J. Public Health. 84, 932–937.
Mackenbach JP, Kunst AE, Cavelaars AE, Groenhof F & Geurts JJ (1997): Socioeconomic inequalities in morbidity and mortality in western Europe. Lancet 349, 1655–1659.
National Institutes of Health (2000): Osteoporosis Prevention, Diagnosis, and Therapy. Bethesda: NIH Consensus Development Conference Statement.
Ness AR, Smith GD & Hart C (2001): Milk, coronary heart disease and mortality. J. Epidemiol. Community Health 55, 379–382.
Pereira MA, Jacobs DR, Van Horn L, Slattery ML, Kartashov AI & Ludwig DS (2002): Dairy consumption, obesity, and the insulin resistance syndrome in young adults: the CARDIA Study. JAMA. 287, 2081–2089.
Popkin BM, Haines PS & Reidy KC (1989): Food consumption trends of US women: patterns and determinants between 1977 and 1985. Am. J. Clin. Nutr. 49, 1307–1319.
Prättälä R, Groth MV, Oltersdorf US, Roos G, Sekula W & Tuomainen HM (2002): Use of butter and cheese in 10 European countries—a case of contrasting educational differences. Eur. J. Public Health 13, 124–132.
Prättälä R, Karisto A & Berg MA (1994): Consistency and variation in unhealthy behavior among Finnish men, 1982–1990. Soc. Sci. Med. 39, 115–122.
Roos E, Prattala R, Lahelma E, Kleemola P & Pietinen P (1996): Modern and healthy?: socioeconomic differences in the quality of diet. Eur. J. Clin. Nutr. 50, 753–760.
Roos G, Johansson L, Kasmel A, Klumbiene J & Prättälä R (2001): Disparities in vegetable and fruit consumption: European cases from the North to the South. Public Health Nutr. 4, 35–43.
Roos G, Prättälä R & the FAIR-97-3096 Disparities Group (1999): Disparities in Food Habits. Review of research in 15 European countries, publications of the National Public Health Institute, B24, 203. Helsinki: National Public Health Institute.
Schrauwen P & Westerterp KR (2000): The role of high-fat diets and physical activity in the regulation of body weight. Br. J. Nutr. 84, 417–427.
Smith AM & Baghurst KI (1992): Public health implications of dietary differences between social status and occupational category groups. J. Epidemiol. Community Health. 46, 409–416.
Takkouche B, Cadarso-Suarez C & Spiegelman D (1999): Evaluation of old and new tests of heterogeneity in epidemiologic meta-analysis. Am. J. Epidemiol. 150, 206–215.
US Department of Health and Human Services (2000): Healthy People 2010. Understanding and Improving Health. Washington, DC: Government Printing Office.
van Rossum CT, van de Mheen H, Witteman JC, Grobbee E & Mackenbach JP (2000): Education and nutrient intake in Dutch elderly people. The Rotterdam Study. Eur. J. Clin. Nutr. 54, 159–165.
Acknowledgements
This study was supported by the FAIR-program of the European Union (project, FAIR-97-3096). Other members of the FAIR-97-3096-project are: Margit Groth (Denmark), Christianne Hupkens (The Netherlands), Sören Jansson (Sweden), Lars Johansson (Norway), Anu Kasmel (Estonia), Jurate Klumbiené (Lithuania), Ada Naska (Greece), Michael Nelson (UK), Ulrich Oltersdorf (Germany), Anne-Marie Remaut-De Winter (Belgium), Wlodzimierz Sekula (Poland), Antonia Trichopoulou (Greece, project coordinator), Kerstin Trygg (Norway) and Sharon Friel (Ireland). We are also grateful to Jokin de Irala, Isabel López-Azpiazu, Miguel Delgado-Rodríguez, Carmen de la Fuente, Juan Llopis and Aurelio Barricarte (Spain) and to all the investigators who have provided unpublished data to be included in this meta-analysis.
Author information
Authors and Affiliations
Consortia
Corresponding author
Rights and permissions
About this article
Cite this article
Sanchez-Villegas, A., Martínez, J., Prättälä, R. et al. A systematic review of socioeconomic differences in food habits in Europe: consumption of cheese and milk. Eur J Clin Nutr 57, 917–929 (2003). https://doi.org/10.1038/sj.ejcn.1601626
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1038/sj.ejcn.1601626
Keywords
This article is cited by
-
Socioeconomic differences in dietary habits in Italy before and during COVID-19 pandemic: secondary analysis of a nationwide cross-sectional study
BMC Public Health (2024)
-
A comparison of diet quality indices in a nationally representative cross-sectional study of Iranian households
Nutrition Journal (2020)
-
Interpretation of milk research results
Osteoporosis International (2018)
-
Climates on incidence of childhood type 1 diabetes mellitus in 72 countries
Scientific Reports (2017)
-
Soziale Ungleichheit im Ernährungsverhalten
Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz (2016)